Efektivitas Pemberian Cairan Praoperatif Ringer Laktat 2 mL/kgBB/jam Puasa untuk Mencegah Mual Muntah Pascaoperasi

Abstract

Teknik nonfarmakologi yang dapat dilakukan untuk menurunkan angka kejadian mual muntah pascaoperasi adalah pemberian cairan praoperatif. Tujuan penelitian ini untuk mengetahui efektivitas pemberian cairan praoperatif Ringer laktat 2 mL/kgBB/jam puasa untuk menurunkan angka kejadian mual muntah pascamastektomi. Penelitian ini merupakan uji klinis acak yang dilakukan pada bulan Maret–April 2013 di Rumah Sakit Kanker Dharmais, Rumah Sakit Persahabatan, Rumah Sakit Fatmawati, dan Rumah Sakit Cipto Mangunkusumo Jakarta, pada pasien status fisik American Society of Anesthesiologist (ASA) 1–2. Sebanyak 102 pasien diacak ke dalam kelompok hidrasi dan kelompok kontrol. Analisis data dilakukan menggunakan uji chi-kuadrat. Terdapat perbedaan yang signifikan dalam kejadian mual pada 0–1 jam pascaoperasi (kelompok hidrasi 20% vs kelompok kontrol 39%) dan pada 0–24 jam pascaoperasi (kelompok hidrasi 22% vs kelompok kontrol 41%). Walaupun tidak berbeda secara statistik, angka kekerapan mual pada 1–24 jam pascaoperasi lebih rendah pada kelompok hidrasi 12% (6) dibandingkan dengan kelompok kontrol 23% (12). Tidak ada perbedaan secara statistik pada angka kekerapan muntah di kedua kelompok penelitian. Pemberian cairan praoperatif Ringer laktat 2 mL/kgBB/jam puasa efektif untuk menurunkan angka kejadian mual pascaoperasi mastektomi pada 1 jam pertama pascaoperasi.  

Kata kunci: Cairan praoperatif, mastektomi, mual muntah pascaoperasi

Effectiveness of Pre-operative Lactated Ringer’s Solution 2 mL/kgBW/h in Fasting Patients to Prevent Post-operative Nausea and Vomiting


Non pharmacologic approaches to overcome post operative nausea and vomiting include giving pre-operative hydration. The objective of this study was to learn the efficacy of pre-operative lactated Ringer’s solution (2 mL/kgBW/hour) in fasting patients to overcome the post-operative nausea and vomiting in mastectomy surgery. This study was a randomized clinical trial that conducted in March to April 2013 in Dharmais Hospital-National Cancer Center,  Persahabatan Hospital, Fatmawati Hospital, and Rumah Sakit Cipto Mangunkusumo Jakarta to patients with  American Society of Anesthesiologist (ASA) physical status 1–2. A total of 102 patients were randomized into the hydration group and control group. Data analysis was performed using chi-square test or appropriate test using SPSS ver. 15. There were statistically significant differences in the incidence of nausea at 0–1 hour post-operative (19.6% in hydration group vs. 39.2% in control group) and at 0–24 hours post-operative (21.6% in hydration group vs. 41.2% control group). The incidence of 1–24 hours PONV, although not statistically significant, was higher in the control group (11.8% in hydration group vs. 23.5% in control group). There was no difference in vomiting incidence between the two groups. Pre-operative lactated Ringer’s solution 2 mL/kgBW/hour in fasting patients effectively reduces the incidence of post-operative nausea one hour after operation.

Key words: Mastectomy, post-operative nausea and vomiting pre-operative hydration

DOI: 10.15851/jap.v2n3.332